Study On Clinical Pathway Of Community Rehabilitation For Patients With Ischemic Stroke

Objective:This study focuses on the effect of rehabilitation program of community rehabilitation clinical pathway about ischemic stroke and its economic benefits.It also provides data support for optimizing and popularizing the clinical pathway of community rehabilitation for stroke.Methods:This study follows a principle of a multicente?single blind?parallel random controlling.It collects the third stage of rehabilitation treatment of 247 cases of cerebral infarction patients after the first two stages,which were randomly divided into rehabilitation group(n=129)clinical path and conventional rehabilitation group(n=118).We put the experimental group into the community rehabilitation clinical pathway and perform the appropriate rehabilitation programs,and put another group into the conventional rehabilitation therapy without requirement on the content and time.The activities of daily activities,motor function and quality of life of the two groups were analyzed from the data which motor function score in the group after 0,4,8 weeks with The Fugl-Meyer assessment(FMA),modified Barthel index(MBI),stroke quality of life score(SQOL).It also analyzed the cost-effectiveness relationship by comparing the two groups of hospital costs.Result:The patient's total scores of MBI in two groups were significantly increased in 4th and 8th week after community rehabilitation(P<0.05),The patient's total score of MBI was significantly higher than that of the routine rehabilitation group in 4th week comparing to when entering group and in 8th week comparing to when the 4th week.The patient's total scores of FMA in two groups were significantly increased in 4th and 8th week after community rehabilitation comparing to when entering group(P<0.05),The FMA scores of the upper limb in the clinical pathway group after 8 weeks were higher than those in the routine rehabilitation group(P<0.05),The FMA scores of the clinical pathway group were significantly higher than those of the routine rehabilitation group in 8th week-admission(P<0.05),At the end of the 4 week,there was statistically significant increase in the upper limb FMA score(P=0.04),The value of FMA in the clinical pathway group was significantly higher than that in the routine rehabilitation group(P<0.05)at the end of the 8 week-4 weekend.The SS-QOL scores of the two groups at the 8 weekend after rehabilitation treatment were significantly higher than those in the group(<0.00),there was no significant difference in SS-QOL score between the two groups(P>0.05),After 8 weeks of treatment,the SS-QOL score of the clinical pathway group was significantly higher than that of the routine rehabilitation group(P<0.05).When MBI score increasing 1 point,the patients of conventional rehabilitation group spent 615.52 yuan more than that of the clinical pathway group(P<0.05).Conclusion:Community rehabilitation clinical pathway can effectively improve the motor function and activities of daily living in patients with cerebral infarction,improve the quality of life,and improve the cost-effectiveness ratio.